精子DNA碎片指数(DFI)对评估体外受精-胚胎移植(IVF-ET)妊娠结局的价值分析

目的探究用精子DNA碎片指数(DFI)评估体外受精-胚胎移植(IVF-ET)妊娠结局的临床价值。方法选取收治的的体外受精-胚胎移植(IVF-ET)患者450例,依据男方精子DNA碎片指数(DFI)的差异分为高碎片组(DFI≥25%)100例与低碎片组(DFI<25%)350例,对比分析两组的卵裂率、受精率、优质胚胎移植率、优质胚胎率与临床临床妊娠率。结果低碎片组受精率,优质胚胎率与临床妊娠率明显高于高碎片组,差异有统计学的意义(P<0.05)。两组卵裂率、优质胚胎移植率比较,差异无统计学的意义(P>0.05)。ROC曲线判定DFI切点为12.5%对预测接受IVF-ET术患者临床妊娠有86.3%的灵敏度和77.4%的特异度(P=0.038)。结论精子DNA碎片指数(DFI)低可以提高体外受精-胚胎移植(IVF-ET)的受精率、优质胚胎率与临床妊娠率,对卵裂和优质胚胎的移植的影响不大。     

优选后精子DNA碎片指数及与体外受精的关系

目的探讨优选前和优选后精子DNA碎片指数(DFI)的变化及其对体外受精(IVF)的影响。方法检测105例IVF助孕患者男方精液密度梯度离心优选前及优选后的精子DFI,分析优选前后精子DFI与IVF受精率、卵裂率、优质胚胎率、妊娠结局等的关系。结果优选处理后精子DFI较处理前明显降低,差异有统计学意义[(13.88±8.63),(29.68±9.94),P0.05];优选后的精子DFI与IVF受精率呈负相关关系(P0.05)。结论优选后精子DFI与IVF受精率密切相关,其对IVF的受精率具有预测价值。     

正常形态精子百分率联合精子DNA碎片指数对体外受精-胚胎移植结局的预测价值

摘要:目的探讨男性 正常形态精子百分率联合精子DNA碎片化指数对体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析2020年6月至2023年2月在本中心行IVF-ET的641例患者的临床资料。根据正常形态精子百分率和精子DNA碎片化指数水平,分为A组(正常形态精子百分率<4%,精子DNA碎片化指数<25%,403例)、B组(正常形态精子百分率≥4%,精子DNA碎片化指数≥25%,9例)、C组(正常形态精子百分率≥4%,精子DNA碎片化指数<25%,125例)、D组(正常形态精子百分率<4%,精子DNA碎片化指数≥25%,104例)、A1组(正常形态精子百分率<1% ,精子DNA碎片化指数<25% ,106例)、D1组(正常形态精子百分率<1%,精子DNA碎片化指数≥25% ,60例)。比较各组一般资料、精液参数、胚胎发育及妊娠结局指标。结果各组女方年龄、 男方年龄差异无统计学意义(P>0.05)。A、B、C、D、A1、D1 组的精子活动率、前向运动精子比率、精子总数、受精率指标差异有统计学意义(P<0.05),而可利用胚胎率、优胚率、临床妊娠率、早期流产率、活产率差异无统计学意义(P>0.05)。结论男性正常形 态精子百分率降低和精子DNA碎片化指数升高与精子活动力和总数下降相关,影响IVF-ET 受精率,但对临床妊娠结局无显著影响。联合检测正常形态精子百分率和精子DNA碎片化指数对预测IVF-ET妊娠结局的价值有限。     

精子形态、DNA碎片指数和精浆锌对体外受精-胚胎移植妊娠结局的影响

目的分析精子形态、DNA碎片指数(DFI)和精浆锌对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法选取2015年6月至2019年2月于我院生殖中心行IVF-ET治疗的278例夫妇为研究对象,依据临床妊娠结局将其分为妊娠组(92例)与未妊娠组(186例)。比较两组的一般资料、精液参数及DFI。结果两组的年龄、不育年限、BMI、获卵数、避孕时间、鲜胚移植周期比较,差异无统计学意义(P>0.05)。妊娠组IVF、ICSI周期的精子浓度、前向活动力、精浆锌水平均高于未妊娠组,DFI低于未妊娠组;妊娠组ICSI周期的精子畸形率低于未妊娠组(P<0.05)。结论精子形态、DFI及精浆锌对IVF-ET妊娠结局有明显影响,且DFI可影响精子前向运动,导致精子畸形,影响早期胚胎发育。     

精子线粒体早老素相关菱形样蛋白及精子DNA碎片指数与体外受精-胚胎移植妊娠结局的相关性分析

目的观察行体外受精-胚胎移植的不孕夫妇中男性患者精子DNA碎片指数(DNA fragmentation index, DFI)和精子线粒体早老素相关菱形样蛋白(presenilin associated rhomboid like protein, PARL)水平变化,探讨其与体外受精-胚胎移植妊娠结局的关系。方法行体外受精-胚胎移植的不孕夫妇中男性患者140例,根据临床妊娠情况分为妊娠成功组57例和妊娠失败组83例。2组行体外受精-胚胎移植前,采用精子染色质扩散法检测精子DFI,采用ELISA法检测精子线粒体PARL水平,比较2组年龄、精子密度、精子活力、精子DFI、精子线粒体PARL水平及优质胚胎率等临床资料。以精子DFI、精子线粒体PARL水平的平均值25%、5.86μg/L为临界值,将140例患者分为高DFI组62例(DFI≥25%)和低DFI组78例(DFI<25%),高PARL组71例(PARL≥5.86μg/L)和低PARL组69例(PARL<5.86μg/L);比较高、低DFI、PARL组精子密度、精子活力、精子畸形率、优质胚胎率、种植率、卵裂率、受精率、临...     

男性年龄与精子顶体酶活性及精子DNA碎片指数的相关性分析

目的检测男性精子顶体酶活性和DNA碎片指数,分析男性年龄与其相关性。方法选取2017年2月至2018年3月不孕不育男性患者220例,均行精液常规检查、精子顶体酶活性检查和精子DNA碎片指数(DFI)分析,其中218例患者以年龄维度(30岁,30～39岁,≥40岁)分为A组、B组和C组。检查、比较并进行分析三组患者的精液量、前向运动精子百分率、精子浓度、活动精子百分率、精子畸形率、精子顶体酶活性大小、精子DNA碎片指数DFI及其相关性。结果精子活性比照,C组低于A组、B组(P0.05)。正相关:精子顶体酶活性与前向运动精子和活动精子的百分率之间,精子DFI与前向运动精子、年龄之间;负相关:顶体酶活性与年龄及精子畸形之间,DFI与活动精子百分率、精液量及精子浓度。精子顶体酶活性和精子DNA碎片指数没明显相关性(P0.05)。结论男性生育能力受年龄影响,其精液量虽无明显变化,但精子顶体酶活性下降,DFI升高,精子活性下降,故高龄(≥40岁)男性在生育前应及时咨询医生,检查精子活力,及时诊断及时评估及时治疗,提高生育能力,进而提高优生优育的概率。     

精子DNA碎片率和高DNA可染性对体外受精-胚胎移植妊娠结局的影响

目的探讨精子DNA碎片率(DNA Fragmentation Index,DFI)和高DNA可染性(High DNA Stainability,HDS)对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法回顾性分析接受IVF-ET治疗的590个周期的临床资料,根据男方精子DFI和HDS值将患者分为4组:A1组(DFI<25%,HDS<15%)224例、A2组(DFI<25%,HDS≥15%)62例、B1组(DFI≥25%,HDS<15%)260例、B2组(DFI≥25%,HDS≥15%)44例,比较各组精液常规质量、精子畸形率和妊娠率等。结果在IVF周期中,精子DFI和HDS对精子浓度、活动率、前向运动率、畸形率和临床妊娠率有显著性差异(P<0.05),对精液量无影响(P>0.05)。如以DFI数据分组,精液DFI对精子浓度、活动率、前向运动率有显著性差异(P<0.05),对精液量、精子畸形率和临床妊娠率无影响(P>0.05)。结论精子DFI值和妊娠结局没有相关性,同时分析精子DNA碎片率和高DNA可染性在评估男性生育能力及预测妊娠结...     

不育患者血清维生素D水平与精子DNA碎片化指数相关分析

目的:探讨不孕患者血清25-羟基维生素D[25(OH)D]水平与精子DNA碎片指数(DFI)的相关性,并进一步探讨血清维生素D在男性不育患者中的诊疗价值.方法:对125例男性不育患者分别检测血清25-羟基维生素D水平、精液常规分析与精子DNA碎片化指数等指标,依据25(OH)D水平分为2组,维生素D正常组67例[25(...     

不育患者血清维生素D水平与精子DNA碎片化指数相关分析

目的:探讨不孕患者血清25-羟基维生素D[25(OH)D]水平与精子DNA+碎片指数(DFI)的相关性,并进一步探讨血清维生素D在男性不育患者中的诊疗价值.方法:对125例男性不育患者分别检测血清25-羟基维生素D水平、 精液常规分析与精子DNA碎片化指数等指标,依据25(OH)D水平分为2组,维生素D正常组67例[2...     

精子碎片指数与精子形态的关系研究

目的：探讨精子DNA碎片指数（DNA fragmentation index, DFI）与精子形态学之间的相关性。方法：回顾性分析3 068例男性患者的精液检查结果,将精子DFI分为<15%、15%~30%、>30%共3组,再根据精子形态学检查结果,按照正常形态精子所占比例<4%、4%~10%、>10%将精子分为3组,分析精子不同形态学分组与精子DFI分组间的关系。结果：不同精子DFI分组的正常形态、头部畸形、混合畸形百分比差异无统计学意义（P均>0.05）;不同的精子正常形态率分组间的精子DFI差异无统计学意义（P均>0.05）,用Spearson相关性分析精子DFI与精子形态之间的相关性,结果发现两者间无相关性。结论：本研究发现精子DFI与精子形态学之间没有相关性。     

腹膜透析患者焦虑和抑郁的多因素Logistic回归分析

目的 探讨腹膜透析患者焦虑和抑郁状况及其危险因素,为临床护士对患者心理干预提供依据.方法 选取169例腹膜透析患者,应用Zung's 的焦虑自评量表、抑郁自评量表评估患者的焦虑和抑郁症状,并对影响因素进行单因素及多因素Logistic 回归分析.结果 患者焦虑得分为(41.24±9.11)分,抑郁得分为(48.71±12.06)分.焦虑发生率为17.8%,抑郁发生率为52.6%.焦虑发生的独立危险因素为工作状况、皮肤干燥、皮肤瘙痒、上臂中点围、年龄.抑郁发生的独立危险因素为文化程度、医疗费用、工作状况、食欲、握力、小腿围、有无浮肿、皮肤瘙痒.结论腹膜透析患者存在焦虑抑郁情绪,焦虑和抑郁的发生与多种因素有关.医务人员应重视腹膜透析患者的心理状况,针对患者不同情况实施心理干预.     

老年胃癌患者手术死亡的多因素回归分析

目的 :探讨老年胃癌患者手术后死亡的原因。方法 :用 L ogistic逐步回归分析可能引起老年胃癌患者手术后死亡的 12种危险因素。结果 :L ogistic回归分析显示 :引起老年胃癌患者手术后死亡有 5种危险因素 ,按强弱依次为联合脏器切除、心脏病、低蛋白血症、全胃切除及慢性阻塞性肺病 (P<0 .0 5 )。结论 :术前伴有心脏病、慢性阻塞性肺病、低蛋白血症以及术中行全胃切除、联合脏器切除是导致老年胃癌患者手术后死亡的重要因素 ,应慎重处理     

罹患慢性疾病老干部不规范服药相关因素多元Logistic回归分析

目的调查罹患慢性疾病老干部发生不规范服药的相关因素。方法采用自行设计调查表对352位老干部是否发生不规范服药及其相关因素进行问卷调查,并对调查结果行单因素卡方检验和多元Logistic回归分析。结果年龄、受教育程度、生活自理程度、医疗付费方式、个人月收入、药物种类、对疾病认识错误和对医疗信任度下降等8因素保留于最终回归模型中;最终模型预测判断力为96.6%;生活完全不能自理、医疗费用全额报销的患者分别与生活完全自理和基本医保患者相比,以及每日服用1~6种药物的患者与超过7种药物的患者相比,不规范服药发生比率低;而生活部分自理、医疗费用部分报销和完全自费患者分别与生活完全自理和基本医疗保险患者相比,不规范服药发生比率高;年龄较小、受教育程度低、个人月经济收入少、对疾病认识错误和对医疗信任度下降的患者相对容易发生不规范服药。结论罹患慢性疾病老干部发生不规范服药因素包括年龄、受教育程度、生活自理程度、医疗付费方式、个人月收入、药物种类、对疾病认识错误和对医疗信任度下降。     

乙肝肝硬化并发原发性肝癌危险因素的logistic回归分析

【目的】探讨乙肝肝硬化（hepatitic cirrhosis ,HC）并发原发性肝细胞癌（Hepatocellular carcinoma ,HCC）的危险因素。【方法】选取2011年5月至2016年5月本院收治的133例 HC 并发 HCC 患者作为观察组,选取同期本院收治的 HC 未并发 HCC 患者133例作为对照组（HC 病程≥10年）。收集整理两组患者的临床资料,采用多因素 Logistic 回归分析筛选 HC并发 HCC 的危险因素。【结果】单因素分析结果显示：观察组患者在肝癌家族史（一级亲属）、饮酒史、吸烟史、酒精性脂肪肝、非酒精性脂肪肝、糖尿病史、HBeAg 阳性、HBVDNA ＞104 copies／mL 及未抗病毒治疗等方面的构成比明显高于对照组,差异具有统计学意义（ P ＜0．05）。多因素 Logistic 回归分析结果显示,HC 并发 HCC 的独立危险因素有：肝癌家族史（一级亲属）（OR ＝4．173,95％ CI 1．673～9．602,P ＝0．000）;饮酒指数3～7（OR ＝3．282,95％ CI 1．265～5．273,P ＝0．001）;饮酒指数8～16（OR ＝4．732,95％ CI 1．644～8．574,P ＝0．000）;吸烟指数8～16（OR ＝4．121,95％ CI 1．543～5．288,P ＝0．000）;酒精性脂肪肝（OR ＝4．763,95％ CI 1．442～7．219,P ＝0．000）;糖尿病史（OR ＝3．982,95％ CI 1．743～6．182,P ＝0．000）;HBeAg 阳性（OR ＝3．172,95％ CI 1．543～5．182,P ＝0．001）;HBVDNA （104～105 copies／mL ）（OR ＝5．874,95％ CI 2．382～9．104,P ＝0．000）;HBVDNA（105～106 copies／mL）（OR ＝7．473,95％ CI 2．874～12．129,P ＝0．000）;HBVDNA （106～107 copies／mL ）（OR ＝10．393,95％ CI 6．182～34．645,P ＝0．000）;HBVDNA （≥107 copies／mL）（OR ＝12．475,95％ CI 6．987～39．543,P ＝0．000）;未抗病毒治疗（OR ＝6．122,95％ CI 2．884～8．138,P ＝0．000）。【结论】HBeAg 阳性、HBVDNA ＞104 copies／mL 、未抗病毒治疗、有长期吸烟饮酒史、糖尿病史、肝癌家族史（一级亲属）的 HC 患者发生 HCC 的危险性较高。     

Sperm Freezing and In Vitro Fertilization in Three Substrains of C57BL/6 Mice

Traditional protocols for sperm recovery, cryopreservation, and in vitro fertilization (IVF) have been considerably less efficient for inbred mouse strains, including C57BL/6, than for hybrid and outbred strains. We report here that 3 changes to published and widely used protocols markedly improved fertilization rates for both fresh and frozen–thawed sperm in 3 substrains of C57BL/6 mice (C57BL/6J, C57BL/6NCrl, and C57BL/6NTac). First, the traditional cyroprotective agent was modified by adding amino acids. Second, preincubation of sperm in a preincubation medium containing methyl-β-cyclodextrin and polyvinyl alcohol enabled collection of progressively motile sperm for IVF. Third, we evaluated 3 media for IVF: human tubal fluid (HTF), modified Krebs–Ringer bicarbonate medium (TYH), and minimal essential medium (MEM). HTF and TYH were modified by adding minimal essential amino acids. The methodology reported here increased the IVF rate of both fresh and frozen–thawed sperm and enabled efficient isolation of capacitated viable sperm. Fertilization rates greater than 65% and 40% were obtained with the 3 tested substrains when fresh and frozen–thawed sperm, respectively, were used for IVF. Higher fertilization rates were seen with frozen–thawed sperm from C57BL/6NCrl and C57BL/6NTac mice than from C57BL/6J mice. Among all strains, fresh sperm from C57BL/6NTac mice gave the highest fertilization rate. Of 190 two-cell embryos, 63 (33.2%) developed to term after transfer to pseudopregnant recipient mice. The protocol we detail here provides reliable cryopreservation and recovery of live mice in 3 substrains of C57BL/6, making sperm cryopreservation and IVF a viable choice for preservation and distribution of mouse lines.Abbreviation: CPA, cyroprotective agent, mCPA, modified cryoprotective agent, HTF, human tubal fluid, IVF, in vitro fertilization, MEM, minimal essential medium, PM, preincubation medium, TYH, modified Krebs–Ringer bicarbonate mediumAn exponential increase in the number of mouse lines with induced mutations (including transgenes, targeted mutations, and chemically-induced mutations) from laboratories and commercial suppliers around the world has resulted in a concomitant increase in lines that need to be preserved or distributed for biomedical research.^4,17,31,33 Yet, at the same time, the technical challenges and limitations associated with shipping live mice have increased dramatically due to increased airport security,² ethical concerns, and other impediments, thereby limiting efficient distribution of important mouse models of human disease. Successful and efficient collection, cryopreservation, and reanimation of mouse sperm would be an ideal solution for preservation and distribution of these important in vivo models, whether for biomedical research or for drug discovery and development. However, the current methods for these processes have proven inefficient, difficult to perform, and rate-limiting. Mouse sperm is very sensitive to diverse stresses including mechanical, osmotic, and oxidative conditions.^19-21,33 The raffinose–skim milk method^25,28,35,36 currently predominates in many laboratories worldwide that routinely cryopreserve and store mouse sperm.^22,23,38 However, high-efficiency reanimation appears to be restricted to mice with hybrid or outbred backgrounds and is considerably less effective for inbred mouse strains, including C57BL/6.³⁵ This situation has a considerable effect on mouse models used for biomedical research, given that many transgenic and knockout lines are backcrossed onto inbred backgrounds, most frequently C57BL/6.³⁵In the present study, we focused on 3 aspects for improvement. First, the traditional cryoprotective agent containing a cryoprotectant (raffinose) and membrane protectant (skim milk) was modified to provide better cryoprotection during the freezing and thawing process. Second, frozen–thawed sperm suspensions underwent a preincubation procedure to enrich for progressively motile sperm. Finally, we compared 3 fertilization media and 3 substrains by using established criteria to select an optimal in vitro fertilization (IVF) medium.     

不同浓度乙醇对人精子形态、前向运动力和DNA 碎片指数影响的体外实验研究

目的　探索不同浓度乙醇对体外培养的人精子形态、前向运动力和DNA 碎片指数的影响。方法　采用密度梯 度离心法处理精液后将回收的30 份精子混悬于不同乙醇浓度的精子培养液中,其中对照组0 mg/dl（A 组）,实验组（低 浓度）20 mg/dl（B 组）,C 组（中浓度）80 mg/dl 和D 组（高浓度）160 mg/dl。6h 后检测各组正常形态精子比例、前 向运动精子以及精子DNA 碎片指数。结果　B 组正常形态精子（9.60±2.13）% 与A 组（10.23±2.48）% 相比,差异 无统计学意义（P=0.128）。C 组（8.03±1.96）% 和D 组（5.23±1.23）% 正常形态精子低于A 组,差异有统计学意义 （P=0.011,0.000）。前向运动精子比例依次下降[A 组（73.03±2.83）%,B 组（63.13±4.22）%,C 组（53.03±3.05）%, D组（45.07±2.97）%],差异有统计学意义（F=283.454,P=0.000）。D组精子DFI （20.30±5.06）%,高于A组（12.37±3.68）%、 B组（12.67±3.78）% 和C 组（15.70±4.06）%,差异均有统计学意义（ P=0.000,0.000,0.001）,B 组、C 组精子 DFI 高于A 组,但差异均无统计学意义（P=0.804,0.339）,B 组与C 组精子DFI 比较,差异亦无统计学意义（P=0.478）。     

体外受精后多原核孕卵生成的影响因素分析

目的：探讨体外受精后多原核孕卵生成的影响因素,为降低临床异常受精率探寻可行方法。方法：应用卡方检验分析927个体外受精周期研究多PN生成率与体外受精方式,女方年龄,超促排卵方案,HCG日血清Ez水平和获卵数的关系。结果：（1）常规IVF周期后多PN生成率显著高于ICSI组;当获卵数〉15个和HCG日血清E。〉4000pg／mt时,体外受精周期中多PN生成率显著升高;（2）ICSI周期中,随着女方年龄的增高,多PN生成率显著增高。结论：体外受精周期中多PN生成的机制和影响因素不尽相同,针对不同不孕因素和年龄等人群选择合适的体外受精方式有助于提高正常受精率。     

Role of 3-D Transvaginal Ultrasonography in Women Undergoing in Vitro Fertilization/Intra-cytoplasmic Sperm Injection

Both 2-D and 3-D transvaginal ultrasonography are effective imaging modalities for assessment of ovarian reserve. Our aim was to compare both modalities in assessment of ovarian reserve of women undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Fifty women were scheduled according to their menstrual cycle to be examined by both 2-D and 3-D transvaginal ultrasonography. We found that the average time for computerized analysis of the 3-D ultrasound data was significantly shorter than that for analysis of the 2-D ultrasound data, for both total antral follicle count and ovarian volume. However, there were no statistically significant differences between the methods in total antral follicle count and ovarian volume. We conclude that, where available, 3-D ultrasonography can be used for assessment of ovarian reserve in addition to the biochemical marker, particularly in overcrowded in vitro fertilization centers that need to save time.